Watertown Regional Medical Center, Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

WATERTOWN REGIONAL MEDICAL CENTER, INC

Doing business as

UWHP WRMC Center For Eye Care - Johnson Creek

Practice address

540 Village Walk LN
Ste G
Johnson Creek, WI 53038-9554

Phone

(920) 699-4388

NPI assigned

Dec 29, 2009

Organization subpart

Yes

Parent organization

WATERTOWN REGIONAL MEDICAL CENTER, NNCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert J Kluge

Title

Patient Financial Services Manager

Phone

(920) 262-4784

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• UWHP WRMC Center For Eye Care - Johnson Creek Doing business as

Part of

Watertown Medmorial HSP

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395187200000",
    "number": "1003146929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 HOSPITAL DR",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983303",
            "telephone_number": "920-262-4784",
            "fax_number": "920-262-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 VILLAGE WALK LN",
            "address_2": "STE G",
            "city": "JOHNSON CREEK",
            "state": "WI",
            "postal_code": "530389554",
            "telephone_number": "920-699-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERTOWN REGIONAL MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WATERTOWN REGIONAL MEDICAL CENTER, NNC",
        "enumeration_date": "2009-12-29",
        "last_updated": "2014-03-19",
        "status": "A",
        "authorized_official_last_name": "KLUGE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PATIENT FINANCIAL SERVICES MANAGER",
        "authorized_official_telephone_number": "920-262-4784"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100007050",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UWHP WRMC Center For Eye Care - Johnson Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Guillermo Miguel Valenzuela Cortez, MD
• Jenell Lynn Valenzuela, APNP
• Kim Vetuschi
• Village of Johnson Creek
• Watertown Regional Medical Center Inc
• Lyndsey Webster, M.S. CCC-SLP
• Tory Lee Wetter, NP
• Ladd E. White, CSAC AND LPC

• Ophthalmology Physician in Johnson Creek, WI
• Providers in Johnson Creek, WI by specialty
• Ophthalmology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.